We desperately need transparency in the cost of medical testing and supplies to make Healthcare more affordable. Our current Healthcare system is, in many ways, a Sickcare System as many preventative health tests are not covered by the large insurance companies.


The Functional Medicine Center pledges to inform you of all costs up front. Because we value collaboration, education and empowerment this post is to help explain the benefits of our Negotiated Rates for lab testing and to help you understand some of the terms of your health insurance coverage. We have spent countless hours negotiating with the 2 largest laboratories in America as well as dozens of specialty labs. The result is that we can usually offer our patients testing for less than anywhere else.


If you decide to use Negotiated Rates for lab testing


1.You receive an invoice from TFMC for the tests you and your provider agreed upon.
2.You pay the invoice directly to TFMC.
3.We provide you the order to take to the lab to have your blood drawn. That’s it. There’s no authorization needed. No guesswork about your costs what your cost may be. And no surprise bill for thousands of dollars for something your insurance doesn’t cover.


Why should I use Negotiated Rates instead of insurance?


If your insurance pays for all your labs without exception, by all means take advantage of this and use your insurance.


We have seen over and over that it just doesn’t work that way. Insurances arbitrarily deny claims, demand letters or appeals from providers, claim that a diagnosis code doesn’t warrant having the test performed or countless other reasons. Patients can be left with a huge bill and we do not have the resources to help. TFMC has opted out of all insurances including Medicare.


Below is an actual Explanation of Benefits from Blue Cross Blue Shield from December 2023 as well as an invoice from TFMC for our Negotiated Rates for the same tests.


Test Name and CPT Code

Insurance Price

TFMC Negotiated Rate

T3, Free (84481)



T4, Free (84439)



Reverse T3 (84482)

NOT COVERED ($116.56 bill to patient from lab)


TPO Antibodies (86376)



Thyroglobulin Antibodies (86800)



TSH (84443)



Vitamin D 25-Hyrdoxy (82306)



Homocysteine (83090)

NOT COVERED ($201.97 bill to patient from lab)


Iodine (83789)

NOT COVERED ($84.37 bill to patient from lab)




BCBS did not cover Reverse T3, Homocysteine, or Iodine. In this case the patient had already met their max out of pocket for the year, and all labs should have been paid for in full, but they still received a bill from the lab for hundreds. Our negotiated rate for these tests totaled $91.13.  Blue Cross decided that they would not cover reverse T3 unless the patient was pregnant. Unfortunately, even when you have a written policy and you know what you’ve purchased at the beginning of the year the insurance company can change what they will cover, regarding lab testing, at any time.



If you decide that you would like to use your health insurance for your lab order, then please be sure that you understand your policy’s deductible, co-insurance, co-pay and out out of pocket maximum.  We can not assume responsibility for deciphering what insurance will cover, or what you may owe the lab.


We believe that the current system is a greedy, corrupt, for profit system and we are thrilled to offer you affordable, quality care without the constraints of insurance.